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Lankford, Hern Defend Religious Liberty of Hospitals

WASHINGTON, DC – Senator James Lankford (R-OK) and Representative Kevin Hern (OK-01) led 31 Senators and Representatives on a letter to CMS Administrator Chiquita Brooks-LaSure, HHS Secretary Xavier Becerra, and The Joint Commission President Jonathan Perlin regarding religious liberties for hospitals participating in the Medicare program. 

Recent threats to the Medicare status of a faith-based hospital in Oklahoma have raised concerns that CMS is unfairly targeting institutions with religious affiliations. These threats echo the rise in discrimination against faith-based organizations across the country. This letter asks how CMS handles the evaluation of religiously affiliated health care organizations, as well as how CMS has changed its policies under the Biden Administration. It is critical that this process protects the health and safety of the patients seeking care at CMS-approved facilities and does not reflect political or religious bias.

“CMS inexplicably threatened to revoke Saint Francis Hospital’s accreditation because of a religious eternal flame, which is unrelated to healthcare,” said Lankford. “St. Francis is a Catholic hospital seeking to serve all who need care in Tulsa, Oklahoma, and the surrounding region. This was a violation of religious freedom—a bedrock of our nation’s founding. Our Oklahoma delegation immediately worked to stop this injustice and was thankfully successful. The sight of an eternal flame is to give hope—we will not allow any federal agency to extinguish Oklahomans’ right to exercise their freedom of religion—especially in a time of need. We are continuing the work to ensure this doesn’t happen anywhere or to anyone else.”

 “Many of the health care institutions in our nation have roots in the church,” said Hern. “Religious organizations have long played a key role in the care of their communities, something that should be encouraged and celebrated. Recent moves from the Biden Administration to target and threaten hospitals and health care facilities because of their religious affiliations threatens the medical care that millions of Americans depend on. We need answers from the Biden Administration. I’m glad my colleagues are joining Senator Lankford and me in this important effort.”

Signers of the letter include Senators Markwayne Mullin (R-OK), JD Vance (R-OH), Mike Lee (R-UT), Steve Daines (R-MT), Rick Scott (R-FL), Marco Rubio (R-FL), Katie Britt (R-AL), Ted Cruz (R-TX), Kevin Cramer (R-ND), and Mike Braun (R-IN) and Representatives Josh Brecheen (R-OK-02), Stephanie Bice (R-OK-05), Daniel Webster (R-FL-11), Glenn Grothman (R-WI-06), Austin Scott (R-GA-08), Gary Palmer (R-AL-06), Rick Allen (R-GA-12), Brian Babin (R-TX-36), Jeff Duncan (R-SC-03), Chris Smith (R-NJ-04), Jake LaTurner (R-KS-02), Bill Huizenga (R-MI-04), Marjorie Taylor Greene (R-GA-14), Brad Wenstrup (R-OH-02), Greg Murphy (R-NC-03), Dan Bishop (R-NC-08), Randy Weber (R-TX-14), Tim Walberg (R-MI-05), Clay Higgins (R-LA-03), Mike Kelly (R-PA-16), and Ronny Jackson (R-TX-13). 

Groups supporting the letter include ACLJ Action, Ethics and Public Policy Center (EPPC), Ethics and Religious Liberty Commission (ERLC), National Catholic Bioethics Center, Students for Life Action, US Conference of Catholic Bishops, Concerned Women for America, and Christ Medicus Foundation.

The text of the letter can be found HERE and below:

Dear Secretary Becerra, Administrator Brooks-LaSure, and Mr. Perlin, 

We write today with concerns about how the Centers for Medicare & Medicaid Services (CMS) handles recommendations from The Joint Commission (TJC) when evaluating hospitals with respect to participation in the Medicare Program. Termination from Medicare is a serious and rare penalty, often resulting in the closure of terminated facilities. It is critical that this process protects the health and safety of the patients seeking care at CMS-approved facilities and does not reflect political or religious bias.

According to CMS’s Framework for Health Equity, “[e]ach person CMS serves should receive … care that is responsive to their … cultural health beliefs and practice, traditions, and other communication needs.” However, it has been brought to our attention that religiously affiliated hospitals have been threatened with loss of Medicare accreditation for the display of religious items. One such hospital, in Oklahoma, was threatened with termination from the Medicare Program after fifteen years of participation for displaying a lit sanctuary candle in the hospital’s chapel.

The right to religious liberty is fundamental to a well-functioning representative democracy and one of our nation’s founding principles. In times of grief and hardship, many Americans turn to their faith for spiritual and emotional healing. The ability to practice one’s faith is a critical part of life, including the healing process, which is one reason why religiously affiliated hospitals provide patients and their families with space to pray and observe their faith.

Further, the government should protect, rather than erect barriers to, the right for religiously affiliated hospitals to live out and operate in accordance with their sincerely held religious beliefs. Such beliefs are often the motivation behind providing health care services to the communities around the country that they serve. It is important that CMS policies do not contain qualifications that would harm or limit the equal participation of religiously affiliated hospitals due to their faith or standards that would put the hospital in the position of choosing between their faith and continuing to operate.

Unfortunately, such threats to religious health care organizations echo the rise in discrimination against faith-based organizations across the country. We are concerned that the current TJC survey process and the CMS review and appeal processes do not include proper safeguards to fairly and appropriately evaluate religiously affiliated hospitals and faith-based health care organizations. We want to ensure these processes protect the health and safety of patients and their religious exercise, as well as the sincerely-held beliefs of hospitals and providers.  As such, please provide the requested information below no later than June 30, 2023.

  1. Since January 20, 2021, how many times has CMS notified a health care organization affiliated with a religious institution that it was at risk of termination from the Medicare program based on recommendations from TJC?
  2. Since January 20, 2021, has CMS rejected appeals from any health care organizations affiliated with religious institutions related to religious exercise, including practices and activities, such as lit candles?
  3. Since January 20, 2021, what policies have changed at CMS regarding the evaluation of health care organizations affiliated with religious institutions? Has there been any change in policy that adversely impacted, or threatened to adversely impact, the long-standing accreditation of any religiously affiliated hospital due to religious activities that CMS previously accommodated?
  4. Describe CMS’ internal process for considering appeals of enforcement remedies that are imposed due to recommendations by TJC? Specifically, does CMS consider its obligations to protect, rather than limit, the religious practices of faith-based hospitals and religious health care organizations after reviewing TJC recommendations? In providing this response, please indicate key decision makers within CMS, either at CMS headquarters or regional offices, at each step of the decision-making process.
  5. Going forward, how will CMS and TJC work together to ensure that health care facilities affiliated with religious organizations do not face an undue hardship or discrimination through this surveying process? 

Thank you for your assistance in this important matter,